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Objective:To investigate the effects of sarcopenia on neurological function and quality of life in patients with cerebral infarction and its risk factors.Methods:Seventy acute cerebral infarction patients with sarcopenia (study group) and 70 age and gender-matched acute cerebral infarction patients without sarcopenia (control group) admitted in Shanxi Bethune Hospital from January 2017 to January 2019 were enrolled in the study. The fat free mass index (FFMI), National Institute of Health Stroke Scale (NIHSS), activity of daily living (ADL) and other related indexes were assessed at the admission and compared between the two groups. Three months after discharge, the neurological impairment, improvement of daily living ability and social regression ability were compared between two groups. Logistic regression analysis was conducted for the risk factors of sarcopenia.Results:The FFMI [(17.70±0.36) vs. (17.90±0.26)kg/m 2, t=3.751, P<0.05], NIHSS9[ (15.00±3.51) vs. (12.17±3.21), t=-4.947, P<0.05] and ADL scores[ (28.64±6.70) vs. (37.14±6.68), t=7.518, P<0.05] of the study group were lower than those of the control group at the admission. NIHSS and ADL scores of the two groups were improved three months after discharge. However, the degree of improvement in NIHSS and ADL of the study group was lower than that of the control group[ (-1.99±1.17) vs. (-3.93±1.47), t=8.651, P<0.05; (6.64±4.32) vs. (15.50±5.05), t=-11.158, P<0.05, respectively]. Meanwhile, the social regression score (SIS) of the study group was lower than that of the control group [ (64.59±5.48) vs.(74.51±4.58), t=-11.639, P<0.05]. Multivariate logistic regression showed that weight loss ( OR=5.094), osteoporosis ( OR=2.856), abnormal hormone levels ( OR=1.885) and comorbid diseases>3 ( OR=2.045) were risk factors of sarcopenia (all P<0.05). Conclusion:Acute cerebral infarction patients with sarcopenia have severe neurological function impairments and decreased activities of daily living. Weight loss, osteoporosis, abnormal hormone levels, and comorbid diseases>3 are risk factors for sarcopenia in cerebral infarction patients.
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This article introduces the background and current status of the involvement of clinical pharmacists in residency training of general practice in Shanxi Dayi Hospital,and also describes their role in general practice team building,clinical medication guidance and teaching practice,to provide reference for the continuous improvement of training management.
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Objective To study the clinical efficacy of unstable angina patients with the treatment of Yixin Kangtai capsule combine with diltiazem .Methods A total of 98 patients with unstable angina were randomly divided into control group and treat-ment group ,49 in each group .The control group was given conventional anti-anginal drug therapy ;while combination group was given Yixin Kangtai capsule combine with diltiazem on the basis of conventional anti-anginal medication .The course was 30 days . After the treatment ,the symptoms of angina ,ECG ST-T ,blood viscosity and markers of endothelial function NO and ET levels were observed .Results After treatment ,the total effective rate of the combination therapy group was higher than that of the con-trol group (P< 0 .05) ;the angina attacks and its duration in combination therapy group were lower than that of control group(P<0 .05) ;the total efficiency of electrocardiogram in combination therapy group was better than that of the control group (P< 0 .05) ;blood viscosity values and ET levels of combination therapy group were reduced compared with before treatment (P < 0 .05) ,but NO levels were increased(P< 0 .05) .Conclusion Yixin Kangtai capsule combine with diltiazem have significant efficacy for unsta-ble angina pectoris ,and have protective effect on endothelial function in patients with unstable angina .
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Objective To investigate the effect of hydroxyethyl starch (HES) 130/0.4 on intraabdominal hypertension (IAH) and inflammatory cytokines in early stage of severe acute pancreatitis (SAP).Methods Clinical data of 55 case of SAP with IAH from Nov 2007 to Oct 2013 in Pancreas Surgery Department of Wuhan Union Hospital were analyzed retrospectively.All patients received conventional treatment without operation.According to the method of fluid resuscitation,patients were divided into treatment group (n =24) and control group (n =31).In treatment group,patients received ringer solution plus 6％ HES 130/0.4 for fluid resuscitation,and patients in control group received only ringer solution for fluid resuscitation.The IAP level,APACHE Ⅱ score and serum inflammatory cytokine from day 1 to 8 were measured.Results The baseline data between the two groups were comparable.The IAP level was significantly lower in treatment group than that in control group from day 5 to day 8 [(10.2 ±2.9),(8.8 ±2.9),(7.9 ± 2.5),(6.9±2.6)mmHg vs (11.9±2.7),(10.5±2.7),(9.5±2.4),(8.6±2.5)mmHg,1 mmHg=0.133 kPa,respectively],and the difference between the two groups was statistically significant (P ＜0.05).There was no significant difference in APACHE Ⅱ score between the two groups,but the decline of APACHE Ⅱ score from baseline (△APACHE Ⅱ score) was more significant in treatment group (P ＜0.05).The serum IL-1 and IL-8 level in treatment group at day 8 was lower than that in control group [(15.1 ± 13.7) μg/L vs (23.6 ± 13.5) μg/L,(11.2 ± 12.8) μg/L vs (23.8 ± 27.9) μg/L,respectively],and the difference between the two groups was statistically significant (P ＜ 0.05).And the serum TNF-α level in treatment group at day 4 and day 8 was lower than that in control group [(31.9 ± 12.1) μg/L vs (43.4 ± 22.4) μg/L,(24.2 ± 12.8) μg/L vs (35.1 ± 15.3) μg/L],and the difference between the two groups was statistically significant (P ＜ 0.05).Conclusions Early fluid resuscitation with HES 130/0.4 and ringer solution relieves IAH,reduces APACHE Ⅱ score and down-regulates IL-1,IL-8 and TNF-α level.
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Objective To investigate the expression of HIF-1 α and toll-like receptor 4 (TLR4) in human pancreatic cancer cell line panc-l under hypoxia.To observe the effect of HIF-1α in the regulation of TLR4 expression in pancreatic cancer cells under hypoxic conditions.Methods Cells were placed in airtight chamber or treated with CoCl2 to mimic tumor hypoxic micro environment.mRNA and protein levels of HIF-lα and TLR4 were detected by reverse transcription-polymerase chain reaction(RT-PCR) and flow cytometric analysis.By RNA interference( RNAi ) originated from small interference RNA (siRNA) to use siRNA was transfected into panc-1 cells.Western blot was used to detect gene scilencing effect on HIF-1α.RT-PCR and flow cytometric analysis was used to observe the change of TLR4 gene expression after HIF-1α gene silence.Results Under hypoxia,both mRNA and protein levels of TLR4 were up-regulated.The siRNA targeting HIF-1α gene down-regulated HIF-1α gene in panc-l cells efficiently,and TLR4 gene was down-regulated as well.Conclusions Hypoxia can increase protein level of TLR4 in pancreatic cancer cells.TLR4 signaling pathway together with HIF-1α may promote development of the pancreatic cancer.
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Objective To detect the expression levels of high mobility group box chromosomal protein 1 (HMGB1) and Th17 cells transcription factors, related cytokines in peripheral blood of rheumatoid arthritis (RA) patients and analyze the relations between HMGB1 and CRP, ESR, RF in RA patients. The other aim of this study is to identify the expression level of HMGBI and the relationship between HMGB1 and Th17 in RA patients. Methods The mRNA levels of HMGB1, RORyt, interleukin (IL)-17 in the peripheral blood mononuclear cells (PBMC) were determined by quantitative real-time PCR (QRT-PCR) from 80 patients with rheumatoid arthritis,including 32 RA patients in stable phase and 48 patients in active phase, and 50 healthy volunteers. The concentration of HMGB1, IL-23, IL-17 in plasma were detected by enzyme linked immunosorbent assay (ELISA), one-way ANOVA and Spearman's correleation were adopted for statistical analysis.Results The mRNAs of HMGBI, RORyt and IL-17 in RA patients were higher than that in healthy control group (P<0.05), especially in active RA patients [ HMGB 1 (0.424±0.262) pg/ml, RORγt (0.34±0.25) pg/ml,IL-17 (1.42±0.38) pg/ml,P<0.01 ] when compared with patients with stable disease. The concentration of HMGB1, IL-23 and IL-17 in the plasma of RA patients was higher than that of the healthy control group (P< 0.05), and was positively correlated with the expression levels of HMGB1, Th 17-associated factors and the level of CRP, ESR, RF in RA patients' plasma(P<0.05). Conclusion The HMGB1 and Thl7 cells levels are higher in active RA patients than those in patients with stable disease, arid there is significant positive correlation between them. Detection of peripheral HMGB1 and Thl7 cell-specific transcription factors or related cytokines can help to understand the development and progress of rheumatoid arthritis and provide clues for new treatment targets for RA.
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The portable high frequency (HF) X-ray machine for field use is introduced in this paper, which applies HF technology and the microcomputer. Compared with the traditional one, it has many new functions such as the self-motion exposal, real-time inspection and display, the alarm of the failure and the automatic disposal. With the advanced technology, it has overcome the deficiencies of the traditional one, including the overweight, bulkiness and unportability. Equipped with the portable mobile shelf, this machine is fit for field operations.
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Objective To design a virtual console for the movable high frequency X-ray machine system type MME2002. Methods An experimental circuit was designed to simulate the real circuit and realized the serial communication between microcomputer and MCU (micro control unit). The simulating software was designed in Visual Basic 6.0, using MSComm to control serial communication. It simulated the functions of the initial console, including setting parameters, sending commands to the machine and storing and transferring the best data of a special condition by file operation in VB. Results The console was designed based on PC. Conclusion This console can replace the console using circuit boards and keys. It can be combined with the X-ray machine systems' image collection software, making the machine's operation more easy and convenient.
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This paper develops a type of x-ray unit which can produce x-ray image suitable for medical diagnosis. The unit is composed of a CCD image sensor with high sensitivity and high resolution, a digital image acquisition board, and a suit of computer software. The software can be applied as the doctor's workstation with the functions of patient register, image process and image management. Some styles of digital radiography technology are introduced briefly, and the principle of the x-ray unit as well as its hardware and software designs are presented particularly.
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Selection of CR and DR is very important for digital radiology departments in modern hospitals. This paper discusses the components of CR and DR as well as their technical requirements.